There is not much “light” in the City of Lights this holiday season I realized, running around in pre-Christmas Paris. Of course, the big department stores have put up their usual tam-tam, but the little streets in the various villages and neighborhoods of Paris are darker than they used to be: “it doesn’t pay off” or “we can’t afford it anymore,” I hear from small merchants who used to put a lot of effort (and obviously a considerable budget) on making the spirit of the holidays come alive. Yes, times are more difficult, and margins have shrunken for many shop owners, but what does it mean that “it does not pay off”? We could now refer to the classic marketing expenditure rule that – as we learned in business school – 50% of expenses are always wasted; you just don’t know which 50%. But more substantially we have to ask why did we put up the lights in the first place and what does “pay-off” mean in this context?

Something went wrong in healthcare – systems around the world seem to be “broken” to a larger or lesser extent and while we diagnose “problems” (rising expenditures, worse outcomes, longer wait times, overworked staff… I could go on and on) there seems to be no urge, no lobby, no real impetus, and courage to get going and do something about it.

I received many emails in response to the first part of my perspective “On the importance of building something together” which led me to the – at least preliminary – conclusion that it pays off to collaborate. However, this individual or also collective pay-off is very diverse as expected. Joint themes circled around “meaning”, “learning”, and “holistic/connected perspectives” which are perceived as particularly enriching in an ever-more specialized work environment in which “siloism” often inhibits the emergence of a communal spirit and joint undertakings.

It seems like everything we do aims at getting attention & airtime these days. The challenge is that attention spans have decreased dramatically since 2010 due to first the wealth of information provided for consumption and second the unchanged fact that the total time of perception and processing is limited. To influence decision-making (and thus buying behavior) the trade-off is to provide evidence & facts – which might take too long – and/or target the affective side of decision-making – which might be quicker but not always work for the message to be conveyed and/or result in undesired decisions.